XN-2000低值血小板聚集报警信息分析及临床特征探索

An Analysis ofAlarming Information and Clinical Characteristicsof Low XN-2000 Platelet Aggregation

目的分析Sysmex XN-2000全血细胞分析仪(以下简称XN-20000)对血小板计数低于正常参考范围下限的标本血小板聚集报警信息的可信性,并探讨与镜检相符病例的临床特征,以期为临床提供最准确的检测结果。方法选取航空总医院血常规检测血小板低于正常参考范围下限的标本,仪器有“PLT Clump?”报警信息的标本416例,血小板无任何报警信息的标本547例,人工染色镜检进行复检,同时搜集临床信息,分析临床特征。结果XN-2000对低值血小板聚集报警与人工染色镜检结果的一致性尚可(Kappa值为0.448)。其警示值与人工染色镜检血小板符合率呈正相关(r=0.994,P<0.01)。聚集符合率较高的前5个科室分别为急诊科[58.1%(18/31)]、产科[55.3%(47/87)]、ICU[53.3%(8/15)]、体检中心[47.3%(9/19)]以及呼吸内科[46.9%(15/32)],除采血及EDTA引起的假性血小板减少外,妊娠[19.7%(13/66)]、手术[18.6%(12/66)]、恶性肿瘤[12.1%(8/66)]及严重感染[12.1%(8/66)]是主要因素。结论XN-2000对低值血小板聚集的报警可信性尚可,警示值越高可信性越大。针对符合率较高的科室及疾病,检验人员应特别注意复查,加强与临床沟通,保证结果的准确性。

Objective To analyze the credibility of platelet aggregation alarming information of samples which platelet count is lower than the lower limit of normal reference range by Sysmex XN-2000 whole blood cell analyzer(hereinafter referred to as XN-20000),and to explore clinical characteristics of the cases consistent with microscopic examination,so as to provide more accurate detection results for clinical practices.Methods We selected samples with platelets tested by blood routine in the General Aviation Hospital and the value was lower than the lower limit of the normal reference range,including 416 cases with“PLT clump?”alarming information and 547 cases without any alarming information.We rechecked the manual staining microscope,collected clinical information and analyzed clinical characteristics.Results The consistency between XN-2000 alarm for low value platelet aggregation and manual staining microscopic examination results was acceptable(Kappa value was 0.448).The warning value was positively correlated with the platelet conformity rate detected by artificial microscope staining(r=0.994,P<0.01).The top five departments with high aggregation coincidence rate were Emergency Department[58.1%(18/31)],Obstetrics[55.3%(47/87)],ICU[53.3%(8/15)],Physical Examination Center[47.3%(9/19)]and Respiratory Department[46.9%(15/32)].In addition to pseudothrombocytopenia caused by blood collection and EDTA,pregnancy[19.7%(13/66)],surgery[18.6%(12/66)],malignant tumor[12.1%(8/66)]and severe infection[12.1%(8/66)]were the main risk factors.Conclusion The alarm credibility of XN-2000 for low value platelet aggregation is acceptable.The higher the alarm value,the greater the credibility.For departments and diseases with high platelet aggregation compliance rate,laboratory technicians should pay special attentions to re-examination and strengthen communication with clinic to ensure the accuracy of results.